Impact of neglected diseases on animal productivity and public health in Africa

Impact of neglected diseases on animal productivity and public health in Africa

21st Conference of the OIE Regional commission for Africa,Rabat, Morocco, 16-20 February 2015

Delia Grace, Mwansa Songe, Theo Knight-Jones

Survey methodology

Survey commissioned and supported by OIE

Sent to 54 Member Countries– 34 responded in time for

inclusion: • 63% response rate• Covers 87% of ruminant, 82%

poultry, 64% pig population in Africa

December 2014-January 20152

Survey Content

1 DISEASE PRIORITIES

4 TRENDS, DRIVERS AND CHANGE

5 COSTS

3 DISEASE PREVALENCE AND CONTROL

6 OPPORTUNITIES

2 MULTIPLEIMPACTS

1. Disease priorities

Pareto principle: the vital few & trivial many

5

0

200000

400000

600000

800000

1000000

1200000

1400000

1600000

1800000

2000000

Top 13zoonoses

Next 43

GBD: top 10 human disease

cause 90% burden

1

10

5

Illnesses

8

6 3

4

9 2

7

Most commonly cited priority diseases

0

1

2

3

4

5

6

7

8

N=109 diseases

Pareto principle: the vital few & trivial many

13

0

200000

400000

600000

800000

1000000

1200000

1400000

1600000

1800000

2000000

Top 13zoonoses

Next 43

GBD: top 10 human disease

cause 90% burden

This survey: 20% of diseases

got 78% of cites

14

2. Multiple impacts

Synoptic view of benefits and costs of animal brucellosis mass vaccination in Mongolia

Distribution of benefits

0

5000000

10000000

15000000

20000000

25000000

30000000

Intervention

cost

Total

Health

Benefits

Public

health

benefits

Private

health

benefits

Household

income

loss

Agricultural

Benefits

Total

Societal

Benefits

Sector

US

$

Roth et al. 2003, Bulletin WHO

‘Combining the total societal benefits, the intervention in the animal sector saves cost, provides the economic argument and thus opens new approaches for the control of zoonoses in developing countries through cost contributions from multiple sectors.’

16

Annual

benefit

Annual cost Confidence

in

investment

Sharing

resources

4 billion 1 billion ++

Controllable

zoonoses

60 billion 20 billion +++

Timely

response

6 billion

3.4 billion

++

Averting

pandemics

30 billion +

Bottom line 100 billion 25 billion +++

A business case for One Health

Disease impacts

Disease

impacts

Disease impacts

Disease

impacts

SVS considerations in deciding most important diseases

19

3. Prevalence and control

21

22

23

24

Priority List Diseases

FMD

PPR

ASF

CBPP

NCD

Anthrax

bTB

RVF

IMPORTANT DISEASES

RVF

FMD

PPR

bTB

Anthrax

Brucellosis

CBPP

Africa: Priority list well aligned with important diseases

PRIORITY DISEASES

1: Avian influenza

3: Leptospirosis

IMPORTANT DISEASES

1: Vector-borne disease

2: Food borne disease

SE Asia: Priority disease not aligned with important diseases

27

Vaccination for priority diseases

28

0

10

20

30

40

50

60

70

80

90

100

Countries with disease present %

0

10

20

30

40

50

60

70

Good control (as % of countries with disease)

4. Trends, drivers and change

30

0 2 4 6 8 10 12 14 16 18 20

Wildlife disease

Emerging zoonotic

Fish disease

Emerging livestock

Food-borne

Endemic

Vector-borne

Epidemic

Zoonotic

Decreasing

Static

Increasing

Most diseases are increasing or static

31

These trends have important drivers

0 20 40 60 80 100 120

Land purchase by foreigners

Inequality

In-migration

Irrigation

Wildlife conservation

Poverty increase

Conflict

Land use change

Biodiversity

Habitat loss

Wildlife areas incursion

Food price

Urbanisation

Deforestation

Economic growth

Social change

Wildlife reservoirs

Intensifying livestock

Human population growth

Trade in livestock & products

Climate change

Drug resistance an increasing threat

32

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Res

po

nd

en

ts o

pio

n o

n A

MR

Common

Occasional

Not present

No information

Foodborne disease a public concern

33

5. Costs

Multiple burdens of animal disease

35

Burden

of illness in people (DALY’s)

Costs of treating disease in people ($)

Losses in agri-food chains

($)

Costs of

Responding to disease in food

chains($)

Costs of preventing disease in

people

Costs of preventing

disease in food chain

Direct impact

Treatment Prevention

People

Animals

Losses due to ecosystem

impacts(?)

Ecosystem

Shaw & Grace, 2014

Annual losses from animal mortality and costs of disease control in Africa

36

0

200

400

600

800

1000

1200

1400

1600

1800

2000

Millio

n U

SD

37

0

200

400

600

800

1,000

1,200

1,400

US

D M

ILL

ION

LO

ST

AN

NU

AL

LY

Losses from cattle disease

38

Losses from sheep & goat disease

0

100

200

300

400

500

600

700

800

900

US

D M

ILL

ION

LO

ST

AN

NU

AL

LY

39

Losses from poultry disease

0

50

100

150

200

250

300

350

400

450

Newcastle Gumboro Coccidiosis Ectoparasites GIT Aflatoxicosis

US

D M

ILL

ION

LO

ST

AN

NU

AL

LY

40

Losses from pig disease

0

20

40

60

80

100

120

140

160

ASF GIT parasites Ectoparasites FMD Erysipelas Cysticercosis

US

D M

ILL

ION

LO

ST

AN

NU

AL

LY

How does this compare to other estimates?

Million USD Value sector

WLDA $39 0.03%SVS estimate $9,000 6%

Literature $30,000 21%BMGF $35,000

41

Million USD Value sector

Australia 979 16%UK 1,178 8%

2/3 from death

1/3 production

Only death

or control

Bennett RM, Ijpelaar J, 2005, Sackett D & Holmes P, 2006

42

Reporting common, non-pathognomonic disease a

challenge

Bovine brucellosis

Predicted cases annual

Bovine brucellosis

Cases reported 2010

East Africa 21,104,976 12

West Africa 30,646,060 37

South Africa 8,492,555 6305

North Africa 7,952,853 1073

Bovine brucellosis

reported 2008-2012

Bovine

brucellosis

according to

440 surveys

Source: LRI report to DFID Mapping poverty and likely zoonosis hotspots

Diagnosis a challenge

43

6. Opportunities

How to improve disease reporting

4570 75 80 85 90 95 100

Affordable, pen side diagnostics

Increased engagement of private vets in diseasecontrol programmes

Investment in information and communicationstechnology

Capacity building in epidemiology

Better links between central and district, local,field veterinary services

Improved information flow between farmers andveterinary services

Increased engagement of farmers in diseasecontrol programmes

Increasing resources for veterinary services

How OIE can help reduce disease impact

4640 45 50 55 60 65 70 75 80 85

Making WAHIS more user friendly

Ensuring OIE focal points have more time for OIEresponsiblities

Improving temporal stability of OIE focal points

Improving synergy between OIE focal points andothers

ARIS and WAHIS inter-operability

Training to focal points

Take homes

Unlimited wants in a world of limited resources

Vital few and trivial many: Pareto principle

The multiple burdens of animal disease

What cannot be measured, cannot be managed

Foreseen is forearmed

Ways Forward

An Africa list of “neglected animal diseases”?

More detailed disease impact studies?

Sharing & harmonisation of contingency plans?

Pilot novel ways to improve reporting?

A One Health system for monitoring animal use of

antimicrobials?

Norms for informal food markets?

Conclusion

Good progress has been made on disease control, priority lists, contingency plans, and vaccination

SVS have broad-based, equitable, development-oriented approach to disease control

But diseases have multiple, heavy burdens and trends are upwards

While new and important threats emerge (climate sensitive disease, EIDs, FBD and AMR)

And limited quantification of impacts may chill investment in disease control

Therefore improved reporting, more information, stronger engagement, and deeper co-operation, is

needed to tackle neglected animal disease in Africa.

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